A rare case of broad ligament ectopic pregnancy

Abstract

Ectopic pregnancy continues to be an obstetric challenge despite the advancement of technology. Abdominal pregnancy is rare (1in 10,000 births) and extremely serious form of extra uterine pregnancy. It can pose a major diagnostic hurdle with many being diagnosed only intra-operatively. We report a case of a 26 year old nullipara who presented with 6 weeks of amenorrhea with abdominal pain since 5 hours and one episode of syncope. She was hemodynamically unstable, routine ultrasound revealed an empty uterus with free fluid in the abdomen. It was diagnosed as a ruptured ectopic pregnancy and taken up for an emergency laparotomy. She had a right broad ligament ectopic pregnancy which had ruptured. Both the tubes, ovaries and uterus was found intact. Excision of the ruptured ectopic mass on the right side of the broad ligament was done. The specimen was sent for histopathological examination and confirmed. Postoperative course was uneventful and serum HCG was undetectable at the fourth week after surgery. Awareness about this rare form of ectopic pregnancy is observational and mainly comes from reported cases. A high index of suspicion is needed for early diagnosis and intervention.